Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 5015750 | NC |
NPI | 1386398337 |
---|---|
Provider Name | Kristiana Tweed Burrell |
First Address | Fairview, NC 28730-7605 |
Second Address | Asheville, NC 28801-4050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2022 |
Last Update Date | 08/02/2022 |